title: Increasing steroid hormone receptors expression defines breast cancer subtypes non responsive to preoperative chemotherapy.
abstract: The predictive role of the degree of endocrine responsiveness to preoperative chemotherapy (PCT) is unclear. We reviewed pretreatment biopsies of 553 patients with locally advanced breast cancer who were treated with PCT. The incidence of pathological complete remission (pCR) and outcome were assessed with respect to the degree of estrogen (ER) and progesterone receptor (PgR) expression (ER and PgR absent, vs. ER or PgR 0-49%, vs. ER and PgR >or=50% of the cells positive). A statistically significant higher pCR rate was observed at the multivariate analysis for patients with ER and PgR absent tumors (17.7%) versus patients with tumors expressing high ER and PgR (0%) (OR 14.4 P < 0.001). Despite the higher incidence of pCR, a statistically significant worse disease-free survival (DFS), and overall survival (OS) was observed for patients with ER and PgR absent tumors versus patients with tumors expressing high ER and PgR (HR 6.4, 95% CI 3.5-11.6, for DFS; HR 3.6 95% CI 2.4-5.6 for OS). Response and outcome after PCT are correlated with the degree of expression of steroid hormone receptors. Studies on tailored preoperative therapies are needed.
authors.affiliation: Department of Medicine, Research Unit in Medical Senology, European Institute of Oncology, Milan, Italy. marco.colleoni@ieo.it
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bagnardi
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.forename: Richard D
authors.initials: RD
authors.lastname: Gelber
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pruneri
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.forename: Rosalba
authors.initials: R
authors.lastname: Torrisi
authors.forename: Anna
authors.initials: A
authors.lastname: Cardillo
authors.forename: Emilia
authors.initials: E
authors.lastname: Montagna
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Campagnoli
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Mattia
authors.initials: M
authors.lastname: Intra
authors.forename: Viviana
authors.initials: V
authors.lastname: Galimberti
authors.forename: Eloise
authors.initials: E
authors.lastname: Scarano
authors.forename: Giulia
authors.initials: G
authors.lastname: Peruzzotti
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm / Q000502:physiology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D020360:Neoadjuvant Therapy; D011960:Receptors, Estrogen / Q000096:biosynthesis*; D011980:Receptors, Progesterone / Q000096:biosynthesis*
chemical_list: D000970:Antineoplastic Agents; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone